The Black Plague

Comes to America-The Opiate

Epidemic
I first tried heroin when I was 16. I drank alcohol and smoked weed for the first
time two weeks earlier and was being quickly initiated into the harder stuff with the help
of my friends. And let me state this here: I dont blame them. From the second alcohol
touched my lips I wanted more I wanted to devour the world.
I remember sitting in a stoned fuzz in my friends living room with about four or
five guys from school and one of them started passing around a sheet of tin foil with a
little piece of black tar on it. They would tilt the tin foil slightly with a lighter lit
underneath and, using the flame, would slide the black ball of tar to the other end as they
inhaled the smoked through a hollowed out pen and then hold it deep within their lungs
as long as possible. When the smell of it hit me, my stomach recoiled. You cant forget
the smell; it is insidious It haunts you forever. One of my friends took a rip and then
passed it to me. With his hand held out I looked down and noticed the cruel black lines
running across the shimmering tin foil, burnt and faded. After a mild protest I submitted
and tried some.
From that point on I couldnt stop. I used every drug I could get my hands on,
recklessly and in excess, and when I drank booze of any sort I would always black out
and piss myself. But when I tried to quit I found that I simply couldnt on my own power.
At first I relied solely on alcohol to help me function, but when I burnt my life to the
ground I switched to heroin and found resurgence. I used drugs and alcohol in excess for

12 years and after going to treatment numerous times, relapsing, going to jail,
overdosing, being shot at, almost losing my arm after using a dirty syringe, having many
friends pass away, and so on and so forth I finally started to work a program of action
with a sponsor and it has been the only thing to keep me clean and sober. But this is not
about my story. My story is unremarkable. In fact it is a common harrowing tale here in
Utah. And nationwide it is becoming an even more familiar story.
My story is a little broad though, so let me narrow it down: why is there an opiate
epidemic in the United States? Is it because it is more accessible these days? Or is
everyone just really depressed and riddled with anxiety that they need an escape valvesomething to numb them from the world and its problems? Everyone knows heroin is bad
for you. It was considered the boogieman of drugs when I was a little kid, followed
closely by crystal meth and cocaine. Not one of my friends or myself could ever have
imagined that we would be transmogrified into strung out junkies by the time we were
seventeen. We were so nave and innocent. Only losers did heroin, everybody knew that!
Then why? Why are so many people, young and old, and from every race and level of
hierarchy in our society being lured into the nightmarish wasteland of opiate addiction?
The opioid epidemic has been called the worst drug crisis in American history.
Death rates now rival those of AIDS during the 1990s, and with overdoses from heroin
and other opioids now killing more than 27,000 people a year, the crisis has led to urgent
calls for action, (http://www.pbs.org/wgbh/frontline/article/how-bad-is-the-opioidepidemic/).
Prescriptions to opioids have tripled since the early 90s, and from 2005 to 2009
there has been a six-fold increase in the amount of heroin smuggled into the states from

Central and South America: 8 metric tons to 50 metric tons. So is it the doctors and
prescription pill companies who are to blame for this? Or is it the cartels and the illegal
immigrants who smuggle black tar and china white heroin into our country and strike
gold when they find a ravenous market of users looking for a cheaper high? It is easy to
see how someone with a pain killer addiction gets hooked on heroin: once their script
runs out they pursue a cheaper high on the street. It leaves one befuddled and suspicious
that this could be a grandiose conspiracy. After all, the pill market primed the heroin
market by putting myriads of dependent users in a state of desperation and the cartels
seemed to be keenly aware of where opiates were booming. There are so many questions
and I dont know if anyone can adequately answer all of them with clarity. It seems to be
an accumulation of many factors that have given wings to this black plague carrying
death and the destruction of lives: a perfect storm, if you will. And in order to comb
through the wreckage and find answers and solutions we have to look back on Americas
sordid love affair with opiates.
The earliest records of opiates in America date back to the first voyage from
Europe. A physician by the name of Samuel Fuller was rumored to have carried
laudanum in his kit bag upon the Mayflower (Laudanum is an opium/alcohol tincture that
was developed by the Swiss-German chemist Paracelsus in 1527 AD). It was effective in
alleviating the pain caused by ailments such as smallpox, cholera, and dysentery, and
became known as a common medical tool by the American Revolution. Thomas Jefferson
relied heavily on laudanum in his old age to relieve his chronic diarrhea and even grew
poppies on his Monticello estate.

By the middle of the 19th century the press began condemning Chinese opium
dens as recreational opiate use was becoming more conventional. But this seemed to be
merely a scapegoat as the prevalence of household opiate use had already entered the
mainstream through commercialization by way of teething powders, soothing syrups,
analgesics for menstrual cramps, etc. I should mention here a big preceding factor in the
opiate explosion of the 19th century. At the outset of the century, in 1806, Friedrich
Wilhelm Adam Sertrner, a German chemist isolated morphine from opium, and, in 1853,
when the hypodermic needle was invented it gave rise to the medicalization of opioids. It
became a staple in medical treatment, being used to treat pain, anxiety and respiratory
problems as well as consumption and menstrual cramps. In the civil war it was used to
treat soldiers with battle injuries. When morphine addiction became so rampant it was
aptly named soldiers disease. And finally, in 1898, the German chemical company
Bayer synthesized a derivative of morphine intended as a cough suppressant and nonaddictive alternative to morphine for medical use called Heroin.
From the 20th century to the 21st century a lot happened and I will do my best to
quickly summarize some of the major events:

Morphine users received free samples of heroin from the Saint James Society to

help them kick their habit.

In 1909 Congress passed the Opium Exclusion Act to halt the importation of

opium.
The Harrison Narcotics Act was passed in 1914, taxing and registering the

distribution of opiates.
The production of heroin stopped because of mass dependence and hazardous use.
A few years later in 1916 oxycodone was created as a less dependent version of
morphine and heroin by German chemists.

In 24 the Heroin Act made the importation, manufacture, and possession of

heroin illegal in the U.S.

In 38 the Food, Drug, and Cosmetics Act was passed which gave the FDA the

authority to oversee all food, drugs, and cosmetics.

Some physicians viewed opiates as an alcohol substitute.
The FDA approved oxycodone as Percodan for mass availability.
The World Health Organization dismissed the idea that the medical use of

morphine inevitably led to dependence.

The Controlled Substance Act was passed in 1970 and categorized drugs into five

separate schedules to rate their value and detriment.

In 73 President Richard Nixon declared a War on Drugs and the Drug

Enforcement Agency (DEA) was created.

Vicodin (hydrocodone and acetaminophen) hit the U.S. markets in 78.
Due to fierce public backlash Doctors became afraid to prescribe a patient

opioids, which became known as opiophobia.

The Reagans launched their Just say NO crusade against drugs and drug users,

further enhancing the stigma that drug addiction was a moral failing.
In 84 4-5 million Americans were reportedly using cocaine and heroin was down

to approximately 500,000 users.

In the early 90s an overwhelming outcry of undertreated pain began a flood of

opioid prescriptions for people experiencing pain of all types and degrees.
In the mid 90s the formulation of time-released opioids were created to meet
the high demand of medicinal pain relief and the drug Oxycontin hit the market

claiming only 1% of users became dependent.

Pharmaceutical companies and healthcare providers began to market opioids more
vigorously and by 1999 an estimated 2.6 million people were misusing their
opioid prescriptions.
And to summarize the dawn of the millennium to today: matters only got worse. It

appears that this sleeping giant was imminent. A powder keg destined to explode.

Everything before the 90s indicates that opiates, no matter what shape or form, have
always been available and there has always been some degree of abuse associated with
them. Is it a matter of population growth- more people, more problems? No I think it is
more simple and obvious. As I said before, the pill market primed the heroin market, and
now that heroin is booming it appears to be inextricable.
In my personal opinion all drugs should be legalized. One of the more obvious
reasons is that people are going to continue to use drugs regardless if they are legal or
not. Furthermore, the boisterous advertisement of alcohol via TV, billboards, radio,
Internet ads, etc. reflects the hypocrisy of our culture. In juxtaposition with alcohol and
cigarettes, the harmful effects of drugs upon our culture pale in comparison. Now some
may say that is because they are legal and are more easily accessible. If you want to
witness how simple it is to buy drugs go to the homeless shelter in Salt Lake City, UT and
observe how easy it is. If you have money and a smidgen of common sense it is as easy
as going through the drive through at McDonald's, and they are open 24/7.
By making opiates legal we would then be able to regulate the purity that would
help reduce the skyrocketing overdose rates here in the States. There is a new drug
concocted in Russian cookhouses that mimics the effects of heroin called Krokodil. This
drug has actually reached the streets of Utah, primarily around the shelter in downtown
SLC. The drug is a concoction of codeine, paint thinner, hydrochloric acid and red
phosphorous scraped from the strike pads on matchboxes. It turns the skin of its users
dark and scaly, like a crocodile, causes swelling to the face, hands, and feet; blood vessels
burst, and surrounding tissue to die, eventually falling off the bone in chunks. The
average life span of its users is two years.

And instead of throwing more money into the war on drugs (a one trillion dollar
failure) we could invest money into more affordable treatment facilities (rehabs) and free
clinics where addicts are provided clean needles to prevent the spread of HIV and
Hepatitis C and other diseases. On another note, our prison system is full of people on
minor drug offenses and the taxpayers are paying for it.
Finally, I attribute almost all of the violence around the U.S./Mexico boarder,
which is rampant, to the cartels and their drug empire. So much of the corruption,
violence, and poverty of Central and South America can be attributed to drugs being
illegal in North America. The cartel has accumulated a staggering amount of wealth and
power because the market is so ripe in the U.S. and it has in turn polluted the economic
and political health of Central and South America. By making drugs legal you remove the
cartels' most valuable source of income.
But this will never happen. Too many people in this country depend on the
illegalization of drugs to fund their livelihood. And putting people out of work to help
junkies, tweakers, and stoners wouldnt go over lightly. The War on Drugs has made four
particular industries rich: the addiction recovery industry, the private prison industry, the
alcohol industry, and the drug testing industry. Whew, Ive drifted way off topic into my
own personal opinions and beliefs about what should be done and the obstacles set in
place to prevent that pipe dream from ever coming to fruition. Perhaps we decriminalize
opiates and other drugs so people can get a fair shot at recovery instead of cycling
through the system. But will some ever be willing to quit if the consequences arent dire
enough for them to recognize the exact nature of their addiction? With all the animosity
directed at the system for failing us in so many ways people have to be held accountable,

especially addicts and alcoholics.

Conclusion
At nineteen, I naively concluded that heroin was a problem confined to Utah and
was a direct result of the predominant religion. But when I started traveling to many
different states across the nation in a desperate attempt to evade the clutches of the black
plague I found that it was running rampant everywhere, like a menacing behemoth
moving stealthily through the shadows devouring all who wander into close proximity of
its poisonous jaws. Americas opiate epidemic has been for the most part quiet due to the
shame underneath the escalating death rates and also because of the confusion on how we
handle the crisis. I applaud the system for beginning to look at the issue of addiction as a
public health issue rather than a moral failing on the part of the addict and instead of
resorting to punitive measures to correct the problem finding ways to get addicts into
treatment of some sort. Progress and immense efforts are being made in spite of the
alarming statistics. Buprenorphine has been called a wonder drug to help opiate
dependence and is much less addicting and easier to kick than methadone, but in my
experience people just stay on this for years and when their script runs out they relapse on
heroin. In my opinion opiate addicts require vital human connection and an altruistic
purpose to get clean and live a normal life, not medication.
This is an epidemic that wont go away over night. It is going to be a long and
harrowing journey out of the abyss. There is a sad truth about opiate addiction that I have
been forced to accept after seeing many people slip away into the cold phantom

wilderness for good and that is, Some make it and some dont. This dismal axiom isnt
merely a pessimistic motto of junkies but a truth that cant be ignored. Not everyone is
going to make it out and live normal lives after their encounter with the indomitable
behemoth. In the rooms of AA, NA, and CA they talk of a spiritual awakening and
revolutionary change which is, in its essence, a connection and relationship with
humanity and a higher power of some kind (this can be anything other than oneself)
which moves addicts and alcoholics from selfish, self centered thinking and behavior to
altruistic consciousness and action. In a society that is becoming more polarized and
divided than ever before it is imperative that we seek to fundamentally change how we
function as a society. Mass shootings are becoming a normal occurrence, there is a
political and racial upheaval seething on the horizon, and opiates are tearing through
small town and inner city America ferociously, and people seem to be too busy or
indifferent to notice the bedlam happening right in front of them. A proactive approach is
a start but there is nothing that can prevent the inevitable and I understand why people are
so jaded, but I feel that doesnt mean people cant educate themselves. I feel deep down
that this is an epidemic that is going to require a nationwide effort, publicly and even
more importantly behind closed doors, to not only remove of stigma of opiate addiction
as a moral failing but to see these people as human beings battling a disease that
decimates the mind, body, and spirit. All human beings require connection and the reason
opiates are indescribably appealing is that they numb the roar of turbulent thoughts and
emotions and to individuals who have been deprived of this essential connection they
embrace this illusion as connection, but truly it is the absence of everything, a vortex of
nothingness that utterly consumes them. So, cultivate awareness in your homes and

attend to this vital connection for your own sake and for the sake of the people you love
because you never know, one day you or someone you care for may be sitting in a room
full of people who are smoking black tar heroin off a strip of tin foil and give in to it just
to escape from the mundane human form and an incessant reality of disconnection and
loneliness.

References

http://www.theatlantic.com/sponsored/purdue-health/a-brief-history-of-

opioids/184/
http://www.theguardian.com/commentisfree/2016/mar/15/long-opiate-use-history-

america-latest-epidemic
http://www.pbs.org/wgbh/frontline/article/how-bad-is-the-opioid-epidemic/
Charles F. Levinthal. (2002). Drugs, Behavior, and Modern Society 8th edition.
Pearson Education Inc, New Jersey.